By Emmanuel Bobby
As the FIFA World Cup prepares to bring millions of soccer fans and thousands of athletes from around the world to North America, public health officials across the United States are intensifying efforts to prevent and respond to potential disease outbreaks during what is expected to be one of the largest international sporting events ever held.
The tournament presents a unique public health challenge because of its unprecedented scale and geographic reach. Unlike events such as the Super Bowl or even the Olympic Games, which are generally concentrated in a single city or region, the World Cup will span multiple cities across the United States, Canada, and Mexico over several weeks. Fans often follow their national teams from venue to venue, creating large-scale movement of people across borders and between host cities.
The expanded tournament will feature 39 national teams establishing training camps throughout the United States. The first match on U.S. soil is scheduled for June 12 in California, while the tournament’s final match will take place more than a month later on July 19 in New Jersey. During that period, millions of visitors are expected to travel through airports, hotels, restaurants, public transit systems, and stadiums, increasing opportunities for infectious diseases to spread.
Health experts acknowledge that with such large crowds, some visitors will inevitably arrive carrying illnesses or become infected while traveling. However, specialists emphasize that the risk varies significantly depending on the disease involved.
Ebola Considered Unlikely Threat Despite Ongoing Outbreak
Although international attention remains focused on the Ebola outbreak in the Democratic Republic of the Congo, infectious disease experts say the likelihood of Ebola spreading during World Cup activities is extremely low.
Unlike respiratory illnesses, Ebola does not spread through the air. Transmission requires direct contact with the bodily fluids of an infected individual, making widespread community transmission at sporting events highly unlikely. Healthcare workers, family caregivers, and those providing direct care to infected individuals generally face the greatest risk of exposure.
As a result, public health officials are far more concerned about diseases that spread easily through casual contact among large groups of people.
Measles Emerges as a Major Concern
Among infectious diseases being monitored ahead of the tournament, measles has become one of the biggest worries for health officials.
The highly contagious virus has already caused significant outbreaks in several parts of the United States and internationally. Because measles spreads through airborne particles and can linger in the air long after an infected person leaves a room, crowded environments such as stadiums, airports, public transportation hubs, and fan festivals create ideal conditions for transmission.
Experts warn that even a single infected individual could expose dozens or even hundreds of people in a crowded venue.
Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health, said he would not be surprised if a measles outbreak were linked to the tournament, noting that large gatherings provide ideal opportunities for the virus to spread.
The challenge with measles is that symptoms often do not appear immediately. The characteristic rash can take up to two weeks to develop, while the virus’s incubation period may extend to three weeks. This delay means individuals could unknowingly spread the disease while traveling or return home before realizing they are infected.
Health officials are particularly concerned that international visitors exposed during the tournament could carry the virus back to their home countries, potentially contributing to additional outbreaks around the world.
Host Nations Increase Surveillance Efforts
The concern is heightened because all three host countries are currently dealing with measles cases. Both Canada and Mexico have reported thousands of infections, prompting regional health authorities to strengthen surveillance measures.
The Pan American Health Organization has urged public health agencies in host cities to improve disease monitoring systems and vaccination preparedness before the tournament begins.
Local health departments have spent months developing contingency plans to respond quickly if cases emerge during the competition.
In Atlanta, one of the tournament’s host cities, public health officials have been preparing extensively for the possibility of measles exposures. Authorities have ensured adequate supplies of vaccines and immunoglobulin treatments, which can sometimes be administered after exposure to reduce the risk of severe illness.
Officials have also developed protocols for a variety of scenarios, including how to handle infected travelers, notify potential contacts, and manage isolation requirements if necessary.
One particularly complex issue involves international visitors who may test positive while staying in hotels or temporary accommodations. Public health agencies have been evaluating how isolation recommendations could be enforced and coordinated for travelers who may not be familiar with local regulations.
The timing of infection further complicates matters. Some visitors could become exposed during the tournament but not develop symptoms until after returning home, making contact tracing and outbreak investigations significantly more challenging.
Seasonal Flu Could Return During Summer Months
While influenza and Covid-19 activity currently remains relatively low across much of the United States, experts caution that the World Cup could alter normal seasonal patterns.
Because the tournament will attract visitors from countries in the Southern Hemisphere, where winter is underway, there is a possibility that travelers could introduce seasonal respiratory viruses that are uncommon in North America during the summer.
Health specialists say imported flu cases could lead to localized outbreaks, especially in crowded indoor environments where fans gather to watch matches or participate in celebrations.
The international nature of the event means healthcare providers may also encounter illnesses rarely seen in the United States, including diseases such as malaria and dengue fever.
Doctors unfamiliar with these infections could face additional challenges diagnosing patients quickly, potentially delaying treatment and increasing complications. Public health agencies are therefore working to ensure healthcare systems remain alert to a broad range of infectious diseases throughout the tournament.
Foodborne Illnesses Pose Significant Risk
While highly publicized diseases often dominate headlines, many public health officials view foodborne illnesses as one of the most likely threats during the World Cup.
Large-scale events create enormous demand for food services, including temporary vendors, food trucks, concession stands, and outdoor festivals. The concentration of visitors increases the risk that contaminated food or poor sanitation practices could lead to outbreaks of illnesses such as norovirus or rotavirus.
These viruses can spread rapidly through contaminated food, water, or surfaces and often cause sudden outbreaks involving nausea, vomiting, diarrhea, and dehydration.
Public health agencies in host cities are placing significant emphasis on food safety inspections. Health departments have assigned teams to conduct daily inspections of temporary food operations, ensuring vendors comply with sanitation regulations and food-handling standards.
Officials say maintaining food safety across hundreds of temporary locations represents one of the largest logistical challenges associated with hosting the tournament.
Advanced Monitoring Systems Ready for Tournament
Federal, state, and local health agencies have developed extensive monitoring systems designed to detect outbreaks as early as possible.
The Centers for Disease Control and Prevention is preparing a specialized dashboard for public health officials that will provide real-time information related to disease surveillance. More than 30 CDC personnel are expected to monitor wastewater data and assist local authorities with tracking potential health threats.
Additionally, approximately 170 federal staff members remain on standby to support states should significant outbreaks or other public health emergencies occur during the tournament.
At the same time, researchers and healthcare organizations are launching new initiatives to improve national health monitoring capabilities.
This week, Georgetown University and MedStar Health announced the creation of a Health Security Operations Center in Washington, D.C. The center will collect and analyze data from multiple sources, including wastewater testing, anonymized electronic health records, and emergency medical reports.
The goal is to identify unusual patterns before they become major outbreaks.
For example, if emergency departments suddenly begin seeing large numbers of patients suffering from gastrointestinal symptoms, analysts can compare those reports with wastewater surveillance data to determine whether a norovirus outbreak may be emerging.
Tracking Crowd Movement to Prevent Outbreaks
One of the most innovative aspects of the monitoring effort involves analyzing mobility data.
Researchers will track large-scale fan movement between cities to better understand how diseases could spread across the tournament’s vast geographic footprint. By monitoring travel patterns, public health officials hope to identify potential transmission routes and provide timely guidance if outbreaks occur.
The Health Security Operations Center plans to issue regular public reports and daily briefings throughout the competition, helping both officials and the public stay informed about emerging health concerns.
Officials Aim for a Safe and Successful Tournament
Despite the challenges associated with hosting millions of visitors, health experts emphasize that extensive planning is already underway to ensure the tournament proceeds safely.
From vaccination preparedness and disease surveillance to food safety inspections and advanced data analysis, agencies at every level of government are coordinating efforts to detect and contain potential health threats before they become widespread problems.
Public health leaders stress that success will ultimately be measured by how little the public notices their work.
If the systems function as intended, fans will be able to focus on enjoying the matches, supporting their teams, and experiencing the global celebration of soccer without major health disruptions. For officials behind the scenes, an uneventful tournament from a public health perspective would represent the best possible outcome.
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